Effectiveness of using ursodeoxycholic acid in reducing incidence of gallstone formation after sleeve gastrectomy

Abstract

Background: Obese persons are at risk for cholesterol gallstones because of high saturation of cholesterol in their bile. About 75% of gallstones are of cholesterol type. To reduce the risk for gallstone formation, policies of prophylactic cholecystectomy are proposed. However, this is not widely accepted. A routine cholecystectomy during bariatric surgery is recommended by some centers. Ursodeoxycholic acid enhances the conversion of cholesterol to bile acids. It also enhances cholesterol transport as liquid crystals. Furthermore, it has an inhibitory action on the prostaglandins and biliary glycoprotein, which is the possible explanation for its action on decreasing the saturation index. The objective was the effectiveness of using Ursodeoxycholic Acid (UDCA) in reducing incidence of gallstone formation after sleeve gastrectomy.Methods: 50 morbid obese patients divided into 2 groups. Group A: 30 patients who received UDCA post-operative. (5 male and 25 female) with mean age 34.8year. Patients had a body mass index (BMI) with mean BMI 46.9kg/m2. Group B: 20 patients without receiving UDCA post-operative. (2 male and 18 female) with mean age 32.9year. Patients had a mean of BMI 47.3kg/m2.Results: Using UDCA has significant role in prophylaxis against development of gall stone formation. Patients who received UDCA developed gall stones by a percentage 0% (0/30) while patients who hadn’t received UDCA developed gall stones by a percentage 4.7% (3/20).Conclusions: The use of UCDA effectively reduced the incidence of gall stone formation after laparoscopic sleeve gastrectomy (LSG) in patient with morbid obesity.